Ophthalmic Emergencies in Benin City, Nigeria

Background: The types and causes of ophthalmic emergencies atthe University of Benin Teaching Hospital, Benin City werestudied prospectively over a 24-month period (January 2002-December 2003).Methods: All emergencies presenting at the University of BeninTeaching Hospital Eye Clinic during this period wererecorded. Cases booked for routine clinic visits were excluded.Also excluded were routine referrals to the eye clinic exceptthey required emergency treatment.Results: Ophthalmic emergencies constituted 1.1% of allemergencies seen in the hospital. Most of those who presentedwere children and young adults < 30 years. Males were moreaffected with a male: female ratio of 2.9:1. Trauma accountedfor 53.4% of the cases. This was either in the form ofcorneal/scleral laceration (22%), traumatic hyphaema(14.4%), ruptured globe (6.1%), lid laceration (4.1%) orburns (6.8%). Non-traumatic causes accounted for 34.1% andwere mostly due to infection/inflammatory causes, presentingeither as panophthalmitis (14.4%), corneal ulcers (10.6%), ororbital cellulitis (9.1%).Conclusion: A two-fold strategy for minimizing ophthalmicemergencies and reducing its devastating effects wasrecommended. Health education would promote the use ofprotective eyewear for high risk occupations, eradicate latepresentation thereby preventing deterioration of minor ocularproblems and minimizing severe complications. Adopting theprinciple of ‘injury control’ will ensure prevention; provideappropriate emergency medical services for the injured as wellas specialized rehabilitation facilities which should attempt toreturn the individual to their former level of functionalit

Prevalence and clinical management of cytomegalovirus retinitis in AIDS patients in shanghai, china

<p>Abstract</p> <p>Background</p> <p>Cytomegalovirus retinitis is a common AIDS-associated illness, leading to blindness in up to 30% of patients. This study was to investigate the prevalence and clinical management of the cytomegalovirus retinitis associated with AIDS in a large municipality of China.</p> <p>Methods</p> <p>Clinical and laboratory data from 23 cytomegalovirus retinitis patients (35 eyes) out of 303 hospitalized AIDS individuals in a single medical center were analyzed retrospectively. Two of 23 patients were diagnosed cytomegalovirus retinitis just before hospitalization without anti-CMV therapy. Ganciclovir combined with the high active anti-retroviral therapy was installed for treatment of cytomegalovirus retinitis after diagnosis was confirmed. The data were analyzed by specialists and statistics was also applied.</p> <p>Results</p> <p>The prevalence of cytomegalovirus retinitis in hospitalized AIDS patients was 7.6% in this study. The level of CD₄⁺T lymphocytes was correlated well with the occurrence of cytomegalovirus retinitis, showing 16.8% (19/113) (95% confidence interval: 10.4,25.0), 5.4% (3/56) (95% confidence interval: 1.1,14.9), and 1.4% (1/69) (95% confidence interval: 0.0,7.8) occurrence in the patients with CD₄⁺T lymphocyte counts < 50, 50~99, and 100~199 cells/μl, respectively. The mean CD₄⁺T lymphocyte counts was 31.7 ± 38.6 cells/μl in 23 AIDS patients with cytomegalovirus retinitis. Median CD₄⁺T lymphocyte count is 20 cells/μl with inter-quartile range as (5, 36). Seven patients died (11 eyes) and 16 patients (24 eyes) survived. The proportion of blindness and low vision in eyes infected with cytomegalovirus retinitis respectively was 20.8% (5/24) and 29.2% (7/24) when they were diagnosed in survivors. The ganciclovir therapy was effective in 16 patients (24 eyes). Clinical recovery of cytomegalovirus retinitis was 41.7% (10/24) and clinical improvement 58.3% (14/24). After anti-CMV treatment, the proportion of blindness or low vision was 16.7% (4/24).</p> <p>Conclusions</p> <p>The AIDS patients with CD₄⁺T lymphocyte < 50 cells/μl had increased susceptibility to cytomegalovirus associated retinitis. Cytomegalovirus retinitis is a serious disease causing blindness. The cytomegalovirus retinitis in the AIDS patients was response well to ganciclovir therapy. We should check their eyes routinely such as dilated fundus examination with an indirect ophthalmoscope in the AIDS patients with CD₄⁺T lymphocyte counts < 50 cells/μl.</p

Traditional eye medicine use by newly presenting ophthalmic patients to a teaching hospital in south-eastern Nigeria: socio-demographic and clinical correlates

<p>Abstract</p> <p>Background</p> <p>This study set out to determine the incidence, socio-demographic, and clinical correlates of Traditional Eye Medicine (TEM) use in a population of newly presenting ophthalmic outpatients attending a tertiary eye care centre in south-eastern Nigeria.</p> <p>Methods</p> <p>In a comparative cross-sectional survey at the eye clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu, between August 2004 - July 2006, all newly presenting ophthalmic outpatients were recruited. Participants' socio-demographic and clinical data and profile of TEM use were obtained from history and examination of each participant and entered into a pretested questionnaire and proforma. Participants were subsequently categorized into TEM- users and non-users; intra-group analysis yielded proportions, frequencies, and percentages while chi-square test was used for inter-group comparisons at P = 0.01, df = 1.</p> <p>Results</p> <p>Of the 2,542 (males, 48.1%; females, 51.9%) participants, 149 (5.9%) (males, 45%; females, 55%) used TEM for their current eye disease. The TEMs used were chemical substances (57.7%), plant products (37.7%), and animal products (4.7%). They were more often prescribed by non-traditional (66.4%) than traditional (36.9%) medicine practitioners. TEMs were used on account of vision loss (58.5%), ocular itching (25.4%) and eye discharge (3.8%). Reported efficacy from previous users (67.1%) and belief in potency (28.2%) were the main reasons for using TEM. Civil servants (20.1%), farmers (17.7%), and traders (14.1%) were the leading users of TEM. TEM use was significantly associated with younger age (p < 0.01), being married (p < 0.01), rural residence (p < 0.01), ocular anterior segment disease (p < 0.01), delayed presentation (p < 0.01), low presenting visual acuity (p < 0.01), and co-morbid chronic medical disease (p < 0.01), but not with gender (p = 0.157), and educational status (p = 0.115).</p> <p>Conclusion</p> <p>The incidence of TEM use among new ophthalmic outpatients at UNTH is low. The reasons for TEM use are amenable to positive change through enhanced delivery of promotive, preventive, and curative public eye care services. This has implications for eye care planners and implementers. To reverse the trend, we suggest strengthening of eye care programmes, even distribution of eye care resources, active collaboration with orthodox eye care providers and traditional medical practitioners, and intensification of research efforts into the pharmacology of TEMs.</p

Possible Role of Drugs and Herbal Medicines in Stevens-Johnson Syndrome

This paper has reviewed three cases of erythema multiforme major who presented with ocular complications. In one of the cases, the patient became blind because of mismanagement. The precipitating factors in the three patients were a herbal remedy, Fansidar® (Sulfadoxine 500mg; Pyrimethamine 25mg) and Thiacetazone, respectively. In this communication, attention is being drawn to the possible role of herbal remedies in the aetiology of Stevens-Johnson syndrome. It is advocated that all patients presenting with features suggestive of erythema multiforme major (Stevens-Johnson syndrome) should be referred, without delay, to a tertiary institution where such patients will have the opportunity of multi-disciplinary management with a view to preventing blindness and other systemic complications. Key words: Erythema multiforme major, eye involvement, drugs, herbal remedies. Résumé Ce papier a review trios cas d'erytheme multiforme majeur qui se sont présentés avec des complication occulaires. Dans l'un cas le patient est devenue aveugle a cause d' un mauvais traitement.les facteurs précipitant dans les trios cas étaient des concoctions d'origine herbals, Fansidar® (Sulfadoxine 500mg, Pyrimethamine 25mg) et du thiacetazone respectivement.dans cette communication l'attention est attire sur le possible role des concoction herbales dans l'étiology du syndrome de Stevens-Johnson. Il est advoqué que tous les patients se présentant avec des symptomes suggerant l'érytheme multiformes majeur (syndrome de Stevens-Johnson) devrons etre transférés sans delai dans une institution tertiaire où ce types de patients béneficiérons d'un traitement multi-diciplinaire en vue de prévenir la cessite et d'autre complication systemiques. Mot clés: Erythème multiforme majeur, emprise occulaire, medicaments, concoction herbales. West African Jnl of Pharmacology and Drug Research Vol.18 2002: 26-3

Case Report: Congenital bilateral eyelid eversion and microphthalmia in co-existence with trisomy 21

A one-year-old male Nigerian child with congenital bilateral eyelid eversion and microphthalmia seen at the University of Benin Teaching Hospital, Benin City is presented. He had phenotypic features of trisomy 21. This case is presented because of its rarity particularly as it is occurring in association with a trisomy. Other associated ophthalmologic features and problems encountered with management are also discussed. Keywords: congenital, eyelid eversion, microphthalmia, trisomy 21 Sahel Medical Journal Vol. 8(1) 2005: 23-2

Effect of Intraoperative Mitomycin C on the Re-currence rate of Pterygium in Nigerians

The aim of this study is to report, on a more comprehensive follow up, the effect of intra-operative mitomycin C on the recurrent rate of pterygium after excision in Benin City, Nigeria. The eyes were treated with intra-operative application of mitomycin C (0.4mg/ml) for three minutes after excision using the bare scleral method and copiously irrigated with normal saline. The total number of pterygia excised was 66 in 51 patients. The age range of the patients was 21 - 60 years with a mean age of 43.7 + 12.7 years. Fifty four pterygia were primary while twelve were recurrent cases. The period of study was January 1998 to June 2001. The period of follow up was from 4 weeks to 3.5 years with a mean of 20.9 weeks. Three (5.6%) of the primary pterygia recurred. Other complications were bacterial conjunctivitis in 4 cases and granuloma in 3 cases. Twelve recurrent pterygia were excised in 10 patients. Seven (58.3%) of these cases recurred. Intra-operative mitomycin C is quite effective in reducing the recurrent rate of primary pterygium, but is not so effective in recurrent cases. The use of intra-operative mitomycin C is strongly recommended after excision of primary pterygia in Nigerians to reduce the rate of recurrence. Key words: Pterygium, recurrence, mitomycin. Résumé Le but de cet étude et le raport plus comprehensif du suivit de l effets intra-opérative du mitomycin C sur le taux de recurrence du pterygium après excision à Benin City, Nigeria. Les yeux ont été traité avec une application intra-opérative du mitomycin C (0.4gmp/ml) pendant trios minutes ce après excision utillisant la methode scleral nue et une irrigation abondante avec une solution saline isotonique (normale). Le nombre total de pterygiums excisés était de 66 sur un total de 51 patients. Leurs ages variants entre 21 – 60 ans avec une moyenne d' age de 43.7+12.7 ans . cinquante quatre pterygiums étaient du type primaire alors douze étaient des cas recurrents. La période d'étude était de janvier1998 a juin 2001. la period de suivit était de 4 semaines à 3.5 ans avec une moyenne de 20.9 semaines. 3(5.6%) de pterygium du type primaire se sont renouvelles . d'autre complications etaient la conjunctivite d'origine bacteriennes(4cas) et des granulome dans 3 cas. Douze pterygiums du type recurrent étaient excises sur 10 patients.7(58.3%) de ces cas se sont renouvellés . L'application intra – opérative du mitomycin C est bien efficace dans la réduction du taux de recurrence du pterygium de type primaire mais pas aussi effectif dans les cas recurrents. L'utilisation intra-operative du mitomycin C est fortement recommend après excision du pterygium du type primaire chez les Nigerian pour reduire le taux de recurrence. Mot clés: Pterygium, recurrence, mitomycin West African Jnl of Pharmacology and Drug Research Vol.18 2002: 17-2

Prevalence of human immunodeficiency virus in opthalmic surgical patients

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The Relationship Between Socio-Demographic Factors and Severity of Visual Field Loss in Glaucoma Patients at Initial Presentation In Benin-City, Nigeria

Late presentation continues to be a major problem of patients with primary open angle glaucoma. The aim of this study is to determine the socio-demographic factors, which affect the severity of visual field loss at initial presentation. A prospective study of 154 new patients with a diagnosis of primary open angle glaucoma seen between January 1997 and August 1998 at the University of Benin Teaching Hospital, Nigeria were analyzed in the context of gender, marital status, religion geographical abode, education status, occupation and monthly income. The patients were examined using the Bjerrum screen. The mean age was 52.73 years (SD+ 15.98) and the male to female ratio was 2.1:1. Eighty-seven patients (56.5%) presented late with visual field constricted to less than 100 of fixation. Gender, marital status, religions and geographical abode did not significantly affect the severity of visual field loss at presentation. There was a significant difference with occupation (P>0.05), educational status (P>0.05) and with monthly income (P>0.01). Patients in the higher socioeconomic classes, those who had tertiary level of education and those in the higher monthly income groups presented earlier than those in the lower socioeconomic classes, those with lower educational status and those in the lower monthly income groups respectively. Economic empowerment, poverty alleviation and improvement in educational status can reduce the problem of late presentation. KEY WORDS:Factors, severity, field loss, glaucoma. Sahel Med. J. Vol.5(4) 2002: 195-19

Ocular morbidities in a targeted high-risk urban population in Benin City, Edo State

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